title: Clinical and radiographic evaluation of a computer-generated guiding device in bilateral sagittal split osteotomies.
abstract: The bilateral sagittal split osteotomy (BSSO) is one of the main orthognathic surgery procedures used for managing skeletal mandibular excess, deficiency or asymmetry. It is known to be a technique-sensitive procedure with high reported incidences of inferior alveolar nerve injury, bad splits and post-surgical relapse. With the increasing use of computer-assisted techniques in orthognathic surgery, the accurate transfer of the virtual plan to the operating room is currently a subject of research. This study evaluated the efficacy of computer-generated device at maintaining the planned condylar position and minimizing inferior alveolar nerve injury during BSSO. The device was used in 6 patients who required isolated mandibular surgery for correction of their skeletal deformities. Clinical evaluation showed good recovery of the maximal incisal opening and a reproducible occlusion in 5 of the 6 patients. Radiographic evaluation showed better control of the condyle position in both the vertical and anteroposterior directions than in the mediolateral direction. The degree of accuracy between the planned and achieved screw positions were judged as good to excellent in all cases. Within the limitations of this study and the small sample size, the proposed device design allowed for good transfer of the virtual surgical plan to the operating room.
authors.affiliation: Oral and Maxillofacial Surgery Department (Prof. Ragia Mounir), Faculty of Oral & Dental Medicine, Cairo University, 11 El-Saraya Street, El-Manial, 11451 Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abdel-Moniem Barakat
authors.affiliation: Oral and Maxillofacial Surgery Department (Prof. Ragia Mounir), Faculty of Oral & Dental Medicine, Cairo University, 11 El-Saraya Street, El-Manial, 11451 Cairo, Egypt. Electronic address: a.abouelfetouh@dentistry.cu.edu.eg.
authors.forename: Adel
authors.initials: A
authors.lastname: Abou-ElFetouh
authors.affiliation: Oral and Maxillofacial Surgery Department (Prof. Ragia Mounir), Faculty of Oral & Dental Medicine, Cairo University, 11 El-Saraya Street, El-Manial, 11451 Cairo, Egypt.
authors.forename: Maha Mohammed
authors.initials: MM
authors.lastname: Hakam
authors.affiliation: Oral and Maxillofacial Surgery Department (Prof. Ragia Mounir), Faculty of Oral & Dental Medicine, Cairo University, 11 El-Saraya Street, El-Manial, 11451 Cairo, Egypt.
authors.forename: Hesham
authors.initials: H
authors.lastname: El-Hawary
authors.affiliation: Central Metallurgical Research and Development Institute (Dr. Khaled Abdel-Ghany), El-Tebbeen, Helwan, 11421 Cairo, Egypt.
authors.forename: Khaled Mahmoud
authors.initials: KM
authors.lastname: Abdel-Ghany
mesh_terms: D000328:Adult; D001863:Bone Screws; D002508:Cephalometry / Q000379:methods; D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003766:Dental Occlusion; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008312:Malocclusion, Angle Class II / Q000601:surgery; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008335:Mandibular Condyle / Q000000981:diagnostic imaging / Q000473:pathology; D008340:Mandibular Nerve / Q000473:pathology; D017090:Occlusal Splints; D059229:Osteotomy, Sagittal Split Ramus / Q000295:instrumentation* / Q000379:methods; D010347:Patient Care Planning; D016059:Range of Motion, Articular / Q000502:physiology; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D061221:Trigeminal Nerve Injuries / Q000517:prevention & control; D014584:User-Computer Interface; D055815:Young Adult
keywords: CAD/CAM; Computed tomography; Computer guided; Condyle position; Image-guided; Nerve injury; Orthognathic surgery; Rapid prototyping; Sagittal split